تعريف

Spinal stenosis is a narrowing of the spinal canal. The spinal canal is located in the backbone. It is a small space that holds the nerve roots and spinal cord. If this space becomes smaller, it can squeeze the nerves and the spinal cord. This causes pain and other symptoms. Stenosis can occur anywhere along the spinal cord. It is most common in the low back (lumbar) region.

Spinal Stenosis 1

أسباب

Some people are born with narrowed canals. Most often stenosis is a result of aging. Conditions that can cause spinal stenosis include:

  • Osteoarthritis and osteophytes (bony spurs) associated with aging
  • التهاب المفصل الروماتويدي
  • Spinal tumors
  • صدمة
  • Paget’s disease of the bone
  • الجراحة السابقة

عوامل الخطر

Factors that increase your chance of spinal stenosis include:

  • Being born with a narrow spinal canal
  • العمر: 50 أو أكبر
  • Previous injury or surgery of the spine

الأعراض

تشمل الأعراض ما يلي:

  • Numbness, weakness, cramping, or pain in the legs and thighs
  • Radiating pain down the leg
  • Abnormal bowel and/or bladder function
  • Decreased sensation in the feet causing difficulty placing the feet when walking
  • Loss of sexual function
  • Partial or complete paralysis of legs

التشخيص

الطبيب سوف يسأل عن الأعراض والتاريخ الطبي. الفحص السريري سيتم القيام به.

قد تشمل الاختبارات ما يلي:

  • X-ray—a test that uses radiation to take pictures of structures inside the body; in this case, to check for abnormalities in the bones of the back including osteoarthritis, bone spurs, and obvious narrowing of the spinal canal
  • CT scan—a type of x-ray that uses a computer to make pictures of the bones of the back, which helps to evaluate the spinal canal
  • MRI scan—a test that uses magnetic waves to make pictures of soft tissue, such as the spinal cord and the spinal nerves inside the back

العلاج

تشمل العلاجات ما يلي:

الدواء

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)—to relieve pain and inflammation
  • Analgesics—to relieve pain
  • Corticosteroid injections—to reduce pain and inflammation

علاج بدني

Special exercises can help stabilize the spinal cord. Exercise can increase muscle endurance and mobility of the spine. This can relieve some pain. Sometimes exercises are ineffective against spinal stenosis.

Support Devices

Wearing a corset or lumbar brace can help stabilize the spine. This may relieve pain.

جراحة

Surgery is reserved for severe cases.

  • Decompression laminectomy —This is the removal of bony spurs or increased bone mass in the spinal canal. This can free up space for the nerves and the spinal cord.
  • الالتحام الشوكي —This is when two vertebrae (back bones) are fused together. This will provide stronger support for the spine. This is almost always done after decompression laminectomy.

الوقاية

There are no guidelines for preventing spinal stenosis.

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